303 3RD AVE NISH CO.
FIRE
DIST40
111 111111--303 390 aLir- /U
ServingBrier, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
wwwFireDistrictl.org Fax (425) 551-1272
LOCATION: 303 3 rd Manua N 9802D
BUSINESS NAME: Rnii�i Bldg kplL PHONE: 42577920.51
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
MAILING LIFIR o 42,� 2021
ADDRESS: SW 3rd Awnuc N, EcInmricL. %jVA 98020
BUSINESS OWNER: M06r, Nnrh-wi HOME PHONE:
EMERGENCY-1: HOME PHONE: '--CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS F-11 [:]
EMAIL: LICENSE L4j-r
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
l-IRE SYS I EMS: FE I' I
HAZARDS FOUND AND LOCATIO CO�M�NICATIONS
1
1
—
2
2
3
3
X
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED C] YES NO
LETTER NEEDED E] YES El NO
8
FIRE DEPARTMENT COPY
Serving Briel-, Edinonds
SNOHOMISH CO.
FIREMountlake Terraceand
S__ 0
the Town f"Wo'odwav
THU; www.Fi0Distr.i,c,tL . org
LOCATION: 303 3rd Avenue
BUSINESS NAME: Ross Bldg Apts
MAILING 301 3rd Av N
ADDRESS: Edmonds
BUSINESS OWNER: iv Ross, Joe (Oly Hills Plum'bing)u
EMERGENCY-1: "Miller, Nadeen (NadeetTS)a
KEY ACCESS-2: Ross, Joe
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
ILI]
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4257782050
98020
HOME PHONE: 4257755829
HOME PHONE: 4257782050
HOME PHONE: 4257713931
FIRE PREVENTION
INSPECTION RF,,f%ORT
14EDMONDS
O'EIRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
e FREQUENCY STATION & SHIFT"
366 17 B
SCHEDULED
DATE DUE 0 09/01/11
LIFIR 0 422 9252
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
6
tE If i III
ANNUAL
HAZARD�FOUND AND LOCATIONS COMMUNICATIONS
me,
2
2
14
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE.
2nd RE -INSPECTION
D E DUE.
EXTENSION
GRANTED TO,
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
-NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
'8
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED 0,::��s El NO
LETTER NEEDED 0 YES El NO
. .
8
FIRE DEPARTMENT COPY
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